VA Struggles To Provide Vets With Mental Health Care

A veteran of the Iraq War with post-traumatic stress disorder talks to physical therapist Nicole Bormann before a session in the VA Medical Center in St. Louis.

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Originally published on April 25, 2012 8:10 am

Over the past five years, the Department of Veterans Affairs says, the number of former service members seeking mental health services has climbed by a third. In response, the agency has boosted funding and tightened standards.

Now, any vet asking for help is supposed to be evaluated within 24 hours and start treatment within two weeks. The VA has claimed that happens in the vast majority of cases, but a new investigation by the agency's inspector general says the VA statistics are skewed to make wait times appear shorter.

Paul Rieckhoff of the Iraq and Afghanistan Veterans of America says that is not surprising.

"It illustrates, in incredible clarity, how dysfunctional the VA system is right now for thousands of veterans around the country," he says.

The inspector general's report says, rather than starting the clock from the moment a vet asks for mental health care, the VA has been counting from whenever the first appointment became available. That could add weeks or months to the wait time.

So while the VA has been saying 95 percent of vets were seen as quickly as they were supposed to be, nearly 100,000 patients had to wait much longer. At the VA Medical Center in Salisbury, N.C., for example, the average wait was three months. Patrick Bellon, an activist with Veterans for Common Sense, says the government has been too slow to increase mental health services.

"You don't see the real cost in human terms until 20 to 30 years after the conflict has ended," Bellon says. "Only recently have we seen an attempt to increase resources to deal with that cost."

Veterans for Common Sense is suing the VA over delays in treatment, and over the time it takes some vets to get benefit payments. The VA announced plans to hire nearly 2,000 additional mental health staff last week, just days before this report came out.

Bellon says he believes that should help.

"I firmly believe the issue is supply, so I'm hoping that if [we] increase the supply, fewer veterans will be turned away," he says.

But there are those who question whether more staff alone will solve the problem. Retired Gen. Peter Chiarelli, former vice chief of staff of the Army, says the supply of good clinicians is not growing fast enough.

"The issue isn't whether the VA hires more behavioral health specialists or whether the military hires more behavioral health specialists," Chiarelli says. "They're hiring them from a set pool. The fact of the matter is we don't have enough."

Chiarelli also thinks understanding of post-traumatic stress and traumatic brain injuries needs to improve, before the military can deal with the more than 1 million veterans who sought help last year.

Attorney Dan Brier is suing the VA on behalf of Stanley Laskowski, an Iraq vet diagnosed with PTSD in 2007. Brier says that even though his client was diagnosed and was in the VA system, he never got the help he needed.

"Since he never received any psychotherapy as the VA protocols require, I'm afraid that in Mr. Laskowski's case, it was an issue of appropriate resources not being available," Brier says.

Laskowski ended up abusing drugs, getting arrested and losing his job; he's seeking millions in compensation from the VA.

The Department of Veterans Affairs declined to comment for this story, but the VA released a statement saying it endorses the inspector general's findings. The agency agrees it needs to change the way it counts wait times, and that it also needs to improve staffing.

The report notes that the inspector general pointed out similar problems seven years ago. At a Senate hearing Wednesday, the VA will have another chance to explain how it's going to do better.

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RENEE MONTAGNE, HOST:

Let's turn now to veterans looking for help. Many of those coming back from war are seeking mental health treatment from the Department of Veterans Affairs. And according to a new government report, they are waiting a lot longer for that treatment than the VA claims. The news comes as the VA struggles to deal with a big increase in the number of vets who need help. NPR's Larry Abramson reports.

LARRY ABRAMSON, BYLINE: Over the past five years, the Department of Veterans Affairs says the number of former service members seeking mental health services has climbed by a third. In response, the agency has boosted funding and tightened standards. Now, any vet asking for help is supposed to be evaluated within 24 hours, and start treatment within two weeks.

The VA has claimed that happens in the vast majority of cases. But a new investigation by the agency's inspector general says the VA statistics are skewed to make wait times appear shorter. Paul Rieckhoff, of the Iraq and Afghanistan Veterans of America, says that's no surprise.

PAUL RIECKHOFF: It illustrates - in incredible clarity - how dysfunctional the VA system is right now, for thousands of veterans around the country.

ABRAMSON: The inspector general's report says rather than starting the clock from the moment a vet asks for mental health care, the VA has been counting from whenever the first appointment came available. That could add weeks or months to the wait time. So while the VA has been saying 95 percent of vets were seen as quickly as they were supposed to be, actually, nearly 100,000 patients had to wait much longer.

At the VA center in Salisbury, North Carolina, for example, the average wait was three months.

Patrick Bellon, an activist with Veterans for Common Sense, says the government has been too slow in ramping up mental health services.

PATRICK BELLON: You don't see the real cost, in human terms, until 20 to 30 years after the conflict has ended. And only recently have we seen an attempt to increase resources to deal with that cost.

ABRAMSON: Veterans for Common Sense is suing the VA over delays in treatment, and over the years it takes some vets to get benefit payments. Conveniently, the VA announced plans to hire nearly 2,000 additional mental health staff last week, just days before this report came out.

Patrick Bellon believes that should help.

BELLON: I firmly believe that the issue is supply. So I'm hoping if we increase the supply, fewer veterans will be turned away,

ABRAMSON: Some question whether more staff alone will solve the problem. Retired Gen. Peter Chiarelli, former vice chief of staff of the Army, says the supply of good clinicians is not growing fast enough.

RETIRED GEN. PETER CHIARELLI: The issue isn't whether the VA hires more behavioral-health specialists, or whether the military hires more behavioral-health specialists. They're hiring those from a set pool. And the fact of the matter is, we don't have enough.

ABRAMSON: Chiarelli also believes our understanding of post-traumatic stress and traumatic brain injuries needs to improve before the military can deal with the more than 1 million veterans who sought help last year.

Attorney Dan Brier is suing the VA on behalf of veteran Stanley Laskowski, an Iraq vet diagnosed with PTSD in 2007. Brier say, even though his client was diagnosed and was in the VA system, he never got the help he needed.

DAN BRIER: Since he never received any psychotherapy - as the VA protocols require - I'm afraid that in Mr. Laskowski's case, it was an issue of appropriate resources not being available.

ABRAMSON: Laskowski ended up abusing drugs, getting arrested, and losing his job. He's seeking millions in compensation from the VA.

The Department of Veterans Affairs would not speak on tape. But the VA released a statement saying it endorses the inspector general's findings. The agency agrees it needs to change the way it counts wait times, and that it needs improve staffing. The report notes that the inspector general pointed out similar problems seven years ago. At a Senate hearing today, the VA will have another chance to explain how it's going to do better.